Individual
DR. IVOR F. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 W OAK ST, FRACKVILLE, PA 17931
(570) 874-4100
(570) 874-4182
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD019501E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000615820
—
PA
Enumeration date
03/28/2006
Last updated
06/02/2020
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